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Prospective NCCTG quality
of life (QOL) study in adult newly diagnosed high-grade gliomas (HGG)
P. D. Brown, K. V. Ballman, T. A. Rummans, M. J. Maurer, J. A. Sloan, B. F.
Boeve, R. M. Arusell, M. M. Clark, J. C. Buckner
Mayo Clinic, Rochester, MN; Roger Maris Cancer Center, Fargo, ND
Background. To assess QOL and the prognostic importance of QOL in adult
patients with newly diagnosed high grade gliomas (HGG), QOL and outcome data
collected in three prospective cooperative group clinical trial were
analyzed.
Methods. The QOL study was a companion protocol for three phase II
protocols; 98-72-51 and 98-72-52 examined pre-irradiation and concurrent
chemotherapy with radiation therapy for patients with anaplastic astrocytomas
and glioblastomas (GBM) respectively, while N0074 investigated maintenance EGFR
inhibitor after radiation was completed for GBMs.
At study entry and at regular intervals, 5 self-administered forms were
completed by the patient to assess
(i) overall QOL (Linear Analogue Scale [LASA] and the Functional Assessment of
Cancer Therapy-Brain [FACT-BR Version 4]),
(ii) fatigue (Profiles of Mood States short form [POMS-SF] and the Symptom
Distress Scale [SDS]),
(iii) excessive daytime somnolence (Epworth Sleepiness Scale [ESS]), and
(iv) depression (Profiles of Mood States short form [POMS-SF]).
Results. Baseline and subsequent QOL data was available for 131 of 220
(60 %) patients enrolled in the 3 prospective trials.
A significant proportion of patients became clinically distressed (QOL <
50) at subsequent evaluations, while the majority of patients distressed at
baseline remained distressed at subsequent evaluations.
Increased fatigue (SDS, p=0.05), depression (p=0.05), and worse QOL (LASA,
p=0.02) at baseline were predictive of worse survival.
Subsequent development of clinical distress was not predictive of
survival.
Conclusions. A significant proportion of patients with HGG become
clinically distressed after treatment.
The majority of patients distressed at baseline remain distressed after
treatment.
Increased fatigue, depression, and worse QOL at baseline predict a worse
survival.
Interventional studies directed to improving QOL are needed.
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Clinically distressed at F/U
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Clinically distressed at baseline and F/U
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SDS Fatigue
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60%
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82%
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LASA QOL
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49%
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74%
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ESS
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41%
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83%
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FACT-BR QOL
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26%
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60%
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POMS Depression
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28%
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42%
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Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-001259,00.asp
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